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  • WHAT IS MEDICAID?
    • DC Medicaid is a healthcare program that pays for medical services for qualified people. Medical payments are made from both state and federal government Monies. It helps pay for medical services for low-income and disabled people. For those eligible for full Medicaid services, Medicaid pays providers of health care. Providers are doctors, hospitals and pharmacies who are enrolled as DC Medicaid Providers.
  • WHERE DO I APPLY FOR MEDICAID?
    • You may apply for Medicaid for low-income families and children under 19 and pregnant women at your ESA Service Center. You may call (202)727-5355 to locate your nearest ESA Service Center. You may apply for benefits at the ESA Service Centers listed below.
    • ESA Service Centers
      Anacostia 202-645-4614 2100 Martin Luther King Avenue, SE
      Congress Heights 202-645-4546 4001 South Capitol Street, SW
      Eckington 202-724-8720 51 N Street, NE
      Fort Davis 202-645-4500 3851 Alabama Avenue, SE
      H Street 202-698-4350 645 H Street, NE
      Taylor Street 202-576-8000 1207 Taylor Street, NE
      Northeast 202-724-7900 3917 Minnesota Avenue, NE

THINGS YOU NEED TO KNOW

  • Freedom of Choice: Most Medicaid recipients may choose the doctor or clinic they wish to use. The doctor or clinic must be willing to accept Medicaid's payment.
  • Other Health Insurance (Third Party Liability / TPL): You must report to the Department of Health Care Finance (DHCF) any health insurance you may have. If you have health insurance and Medicaid, you must give your insurance information to your doctor when you get services. Medical payments from any source (insurance, liability coverage, Worker's Comp, employer liability, CHAMPUS, lawsuits, accidents or other) that you get for services covered by Medicaid must be reported to Medicaid. In order to be eligible for Medicaid, you must assign your rights to medical payments from any source to DHCF.
  • Things You Must Do To Get Health Care Services: Always remember to take your Medicaid ID card every time you go to get health services. Remember that not all doctors, dentists and other providers accept Medicaid. You should always ask the provider if he accepts DC Medicaid before you get services.
  • Civil Rights: Participating providers of services in the Medicaid program must comply with the requirements of Title VI of the Civil Rights Act of 1964 and Section 504 of the Rehabilitation Act of 1973. Under the terms of those laws, a participating provider or vendor of services under any program using federal funds is prohibited from making a distinction in the provision of services to recipients on the grounds of race, age, gender, color, national origin or disability. This includes distinction made on the basis of race or disability with respect to (a) waiting room, (b) hours for appointments or (c) order of seeing patients.
  • Fair Hearings: The Social Security Administration (SSA) holds fair hearings for Medicaid eligibility decisions that are part of a Supplemental Security Income (SSI) decision for low income, aged and blind and disabled individuals. You may call the SSA at 1-800-772-1213.

COVERED SERVICES ALSO INCLUDE

  • Ambulatory Surgical Center
  • Medically Necessary Transportation
  • Dental Services and Related Treatment
  • Dialysis Services
  • Durable Medical Equipment
  • Emergency Ambulance Services
  • Hospice Services
  • Laboratory Services
  • Radiology
  • Medical Supplies
  • Mental Health Services
  • Physician Services
  • Nurse Practitioner Services
  • Home and Community Bases Services (HCBS)
  • Transplants
Medicaid Recipients are encouraged to get a yearly health screening from your doctor or clinic. This Physical examination will not be used to determine your eligibility for the Medicaid Program.

MEDICAID PROGRAMS

  • Home and Community Based Services - DC Medicaid DHCF administers several Waiver programs which include the Mental Retardation Developmental Disabilities (MRDD) Waiver, Elderly and Physical Disabilities (EPD) Waiver, and the Water Filter Program.